Understanding & Overcoming Depression
Goal
To be able to understand depression, how it is impacting you, and how you can help overcome
What is Depression? (Greenberger & Padesky, p. 154)
Depression includes not only sad mood but also numerous cognitive, behavioral, physical, and emotional symptoms. When these symptoms are severe, chronic, or occur repeatedly, they may interfere with our personal relationships or our work.
Cognitive Symptoms
- Self-criticism
- Hopelessness
- Suicidal thoughts
- Concentration difficulties
- Overall negativity
Behavioral Changes
- Withdrawal from other people
- Not doing as many activities that are enjoyable or pleasurable
- Having difficultly “getting started” with activities
Physical Symptoms
- Insomnia
- Sleeping more or less than usual
- Being tired
- Eating less or more
- Weight changes
Emotional Symptoms
- Sadness
- Irritability
- Anger
- Guilt
- Nervousness
Identifying & Assessing Symptoms Exercise (Greenberger & Padesky, pp. 154-156)
Instructions: To help identify the symptoms of depression you are experiencing, rate the symptoms listed in the depression inventory table below. Circle one number for each item that best describes how much you have experienced each symptom over the last week.
Fill out this depression inventory periodically as you complete this course to assess how your depression is changing and which interventions are most worthwhile. Score the inventory by adding up the numbers you circled for all the items. For example, if you circled 3 for each item, your score would be 57 (3 X 19 items). If you couldn’t decide between two numbers for an item and circled both, add only the higher number. Compare your scores once or twice each week to see if your symptoms are decreasing and which symptoms are improving and which are not.
To chart change, record your depression inventory scores in the depression inventory tracking table below. Mark each column with the date you completed the depression inventory. Then put an X in the column across from your score. You may find that your scores fluctuate from week to week or do not improve every time you fill out the inventory. Some weeks your score may be higher (more depressed) than the week before. This is not unusual nor is it a bad sign; in fact, it reflects a pattern of recovery. Decreasing scores over time are a sign that the changes you are making are contributing to your improvement.
| Depression Inventory | Symptom | Not at all | Sometimes | Frequently | Most of the time |
|---|---|---|---|---|
| 1. Sad or depressed mood | 0 | 1 | 2 | 3 |
| 2. Feeling guilty | 0 | 1 | 2 | 3 |
| 3. Irritable mood | 0 | 1 | 2 | 3 |
| 4. Less interest or pleasure in usual activities | 0 | 1 | 2 | 3 |
| 5. Withdraw from or avoid people | 0 | 1 | 2 | 3 |
| 6. Find it harder than usual to do things | 0 | 1 | 2 | 3 |
| 7. See myself as worthless | 0 | 1 | 2 | 3 |
| 8. Trouble concentrating | 0 | 1 | 2 | 3 |
| 9. Difficulty making decisions | 0 | 1 | 2 | 3 |
| 10. Suicidal thoughts | 0 | 1 | 2 | 3 |
| 11. Recurrent thoughts of death | 0 | 1 | 2 | 3 |
| 12. Spend time thinking about a suicide plan | 0 | 1 | 2 | 3 |
| 13. Low self-esteem | 0 | 1 | 2 | 3 |
| 14. See the future as hopeless | 0 | 1 | 2 | 3 |
| 15. Self-critical thoughts | 0 | 1 | 2 | 3 |
| 16. Tiredness or loss of energy | 0 | 1 | 2 | 3 |
| 17. Significant weight loss or decrease in appetite (do not include weight loss from a diet plan) |
0 | 1 | 2 | 3 |
| 18. Change in sleep pattern-difficulty sleeping or sleeping more or less than usual |
0 | 1 | 2 | 3 |
| 19. Decreased sexual desire | 0 | 1 | 2 | 3 |
Score (of total circled numbers) = _____
| Depression Inventory Tracking | Score | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 57 | ||||||||||||||||
| 54 | ||||||||||||||||
| 51 | ||||||||||||||||
| 48 | ||||||||||||||||
| 45 | ||||||||||||||||
| 42 | ||||||||||||||||
| 39 | ||||||||||||||||
| 36 | ||||||||||||||||
| 33 | ||||||||||||||||
| 30 | ||||||||||||||||
| 27 | ||||||||||||||||
| 24 | ||||||||||||||||
| 21 | ||||||||||||||||
| 18 | ||||||||||||||||
| 15 | ||||||||||||||||
| 12 | ||||||||||||||||
| 9 | ||||||||||||||||
| 6 | ||||||||||||||||
| 3 | ||||||||||||||||
| 0 | ||||||||||||||||
| Date: |
Overcoming Depression (Greenberger & Padesky, pp. 160-163)
Depression can almost always be helped. The treatment approaches that have been shown to be most effective in reducing depression include cognitive restructuring, medication, improving interpersonal relationships, and activity scheduling.
Cognitive Restructuring
Depressed people tend to notice and remember negative aspects of their experiences more readily than positive or neutral aspects. They also are more likely to interpret their lives with a negative bias, while non-depressed people interpret events with a positive bias. Exercises in the following lessons will teach you how to test negative thoughts by reviewing all the information in your life-positive and neutral as well as negative. You will learn how to evaluate your negative thoughts and learn to think in more adaptive ways to reduce your depression.
Medication
If you experience intense depression or long-lasting depression, or if your depression includes physiological symptoms, such as disruption in sleep, jitteriness, fatigue, or loss of appetite, you may benefit from a consultation session with a psychiatrist or another physician who can evaluate whether or not medication might be helpful.
Improving Interpersonal Relationships
Some treatments for depression emphasize the importance of improving close relationships. If you are in an abusive relationship or a relationship with someone who criticizes you constantly, it can be hard to recover from depression. Couples therapy or family therapy can help you improve relationship conditions that may be feeding your depression. If you are being physically or sexually abused, almost all communities have special programs nearby to help you.
Activity Scheduling
Activities can be connected to the way you feel. If you track feelings of depression, you may discover that when you are depressed you are more passive and less active. Following the observation that depressed people tend to stop doing pleasurable activities, depression treatments often emphasize increasing the weekly number of pleasurable activities.
Additional ways to improve mood:
- Surround yourself with people who have a positive impact on you
- Invest in friendships and have a “go to” person that you can trust
- Become more forgiving - forgive yourself and forgive others (http://letmebeme1.files.wordpress.com/2011/08/reach-steps-to-forgiveness.doc)
- Build on areas of strength and note evidence for new beliefs that replace old negative beliefs (praise yourself for things you accomplish)
- Keep a gratitude journal (http://www.wikihow.com/Start-a-Gratitude-Journal)
Next Step
Learn more about depression and hear personal testimonials by watching the following video: